Synbiotic supplements may influence metabolic status for diabetics: RCT data

By Stephen DANIELLS

- Last updated on GMT

Synbiotic supplements may influence metabolic status for diabetics: RCT data
A combination of probiotics and prebiotics may reduce levels of markers of inflammation and oxidative stress, suggest findings of a new study publishing in the journal Clinical Nutrition.

Six weeks of supplementation with a combination of Lactobacillus sporogenes​ and inulin were associated with a significant reduction in levels of C-reactive protein (CRP), a marker of inflammation, and increased glutathione levels.

The symbiotic supplements were also associated with improvements in some blood lipid measures, report researchers led by Ahmad Esmaillzadeh from the Isfahan University of Medical Sciences in Iran.

“To the best of our knowledge, this study is the first examining the effect of synbiotic food on metabolic status of diabetic patients,” ​they said.

According the FAO/WHO, probiotics are defined as "live microorganisms which when administered in adequate amounts confer a health benefit on the host".​ Prebiotics are "non-digestible substances that provide a beneficial physiological effect on the host by selectively stimulating the favorable growth or activity of a limited number of indigenous bacteria".​ Synbiotics are a combination of the two.

A recent study presented at the American Gastroenterological Association’s (AGA) Digestive Disease Week screened 7 commercially available prebiotics and 6 commercially available probiotics and found, for example, that short-chain fructooligosaccharide (sc-FOS) prebiotics increased the growth of Bifidobacterium lactis BI-07 more than the other prebiotics.

The study was said to be a large step towards designing the optimal synbiotics for gut health and beyond.

Study details

The new study – a randomized double-blinded cross-over controlled clinical trial with 62 diabetic patients aged between 35 and 70 – suggests there is potential for synbiotics to enhance metabolic parameters for people with type-2 diabetes, a group highly susceptible to metabolic abnormalities, elevated systemic inflammation and oxidative stress.

The participants were randomly assigned to eat a synbiotic food consisting of heat-resistant L. sporogenes​ (1 × 107 CFU) and 0.04 g inulin. A control food was also prepared without the probiotic bacteria and prebiotic inulin. After six weeks of intervention, they underwent a two week washout period and then crossed to the other food group.

Results showed that insulin levels significantly decreased following consumption of a synbiotic food, compared to the control. In addition, there was a trend for triglycerides and HDL-cholesterol levels to improve, they said.

The data also indicated that CRP levels decreased by 1057.86 in the symbiotic group, compared with a slight increase in the control group (95.40 ng/mL).

The synbiotic food was also associated with significants increase in glutathione and uric acid levels, compared to the control food.

Commenting on the potential mechanism, the researchers note that prebiotics and probiotics can enhance the production of short-chain fatty acids (SCFA), which may decrease the expression of inflammation-relevant genes. In addition, one SCFA in particular, butyrate, which leads to NADPH provision for synthesis of glutathione, and an up-regulation of oxidative pentose pathway activity.

“Further studies are required to assess the effect of synbiotics on other inflammatory biomarkers,” ​they wrote.

“Due to the use of different bacteria strains in different studies, the cross-study comparisons are not easy.

“Additional studies must explore the best composition of a synbiotic food (in terms of both bacteria strains and the appropriate prebiotic) influencing metabolic conditions in diabetic patients.”

Source: Clinical Nutrition
Published online ahead of print, doi: 10.1016/j.clnu.2013.05.015
“Effects of synbiotic food consumption on metabolic status of diabetic patients: A double-blind randomized cross-over controlled clinical trial”
Authors: Z. Asemi, A. Khorrami-Rad, S-A. Alizadeh, H. Shakeri, A. Esmaillzadeh

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